Liver cirrhosis is the last stage of liver disease. By this time, the liver has suffered repeated injury. It is finally at the point where the damage is usually irreversible. The most common causes of liver cirrhosis in the United States are chronic alcohol abuse and chronic hepatitis C, according to Eldon Shaffer, M.D., Professor of Medicine at the University of Calgary in "The Merck Manual for Healthcare Professionals."
Chronic Alcohol Abuse
Liver cirrhosis from chronic, or long-term, alcohol abuse usually takes many years. Elizabeth Corwin, Ph.D. explains in "Handbook of Pathophysiology," that the liver is poisoned by products from the digestion of alcohol. In addition, most alcoholics do not eat well. This only makes the problem worse. There are three stages in alcoholic cirrhosis: The first stage is called fatty liver disease. Excessive amounts of alcohol interfere with the metabolism of fats. This causes fats to accumulate within the liver. At this stage, the damage is reversible if people stop drinking alcohol. The second stage is alcoholic hepatitis, or the inflammation of the liver due to alcohol. This stage is also reversible. Cirrhosis is the last stage. Cirrhosis is usually irreversible because the liver has developed so much fibrous tissue, fibrous scars, nodules, and can no longer handle the flow of blood.
Chronic Hepatitis C
Hepatitis is the inflammation of the liver. There are five viruses that can cause a viral hepatitis. Those viruses have the names hepatitis A, B, C, D and E. Lawrence Friedman, M.D., Professor of Medicine at the Harvard Medical School writes in "Current Medical Diagnosis & Treatment," that hepatitis is called chronic if someone has liver inflammation for more than six months. Approximately 1.8 percent of Americans have chronic hepatitis C. Twenty percent of them will develop liver cirrhosis in about 20 years. The risk factors include body piercing, sharing needles from intravenous drug use, being a prison inmate and inhaling cocaine.
Chronic Hepatitis B
Chronic hepatitis B is the inflammation of the liver caused by the hepatitis B virus. Approximately 1.25 million Americans have this disorder and similar to chronic hepatitis C, 20 percent will develop cirrhosis of the liver, according to Bruce Bacon, M.D., Professor of Internal Medicine at Washington University in "Harrison's Principles of Internal Medicine." At one time, there was a risk of contracting hepatitis B from blood transfusions, but the current screening procedures have almost eliminated all contaminated donor blood. There is still a risk of getting this disease from the shared needles of intravenous drug users and through sexual transmission.
Alpha One-Antitrypsin Deficiency
Alpha one-antitrypsin is a protein that protects the lungs from being harmed by neutrophils, a type of white blood cell. Alpha one-antitrypsin deficiency is a hereditary disease whereby the child does not have enough of this protein. This leads to a type of emphysema, a lung disease. But the deficiency also leads to cirrhosis of the liver. Robert Wise, M.D., Professor of Medicine at John Hopkins University School of Medicine writes in the "The Merck Manual for Healthcare Professionals" that the protein accumulates in the liver. Twenty percent of babies will develop cirrhosis of the liver when they are only children. Another 10 percent will develop cirrhosis when they become adults.
References
- "Current Medical Diagnosis & Treatment 2010"; Stephen McPhee, M.D., Maxine Papadakis, M.D.; 2010
- "Handbook of Pathophysiology"; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
- The Merck Manual for Healthcare Professionals: Alpha One-Antitrypsin Deficiency
- The Merck Manual for Healthcare Professionals: Cirrhosis
